Fri Aug 26 2022

70 articles - From Friday Aug 19 2022 to Friday Aug 26 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Nephrol Dial Transplant

Armed conflicts and kidney patients: A consensus statement from the renal disaster relief task force of the ERA.

Preparation for disasters should occur ahead of time. Inclusion of disaster nephrology in medical and nursing curricula and training of patients, families and others on self-care and medical practice in austere settings may enhance awareness and preparedness, support best practices adapted to the demanding circumstances, and prepare non-professionals to lend support.

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Meta-analysis

meta-analyses and systematic reviews

Kidney Int

Kidney disease progression and collider bias in GWAS.

The study illustrated the complexity of modeling longitudinal traits in genome-wide association studies and highlighted the issue of a collider bias that can be introduced when a kidney disease progression phenotype is adjusted for baseline kidney function. Herein, we briefly outline the key findings of this study, their limitations, and implications for future studies.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Am J Kidney Dis

Long-term Health Care Utilization and Associated Costs After Dialysis-Treated Acute Kidney Injury in Children.

Dialysis-treated AKI survivors had greater post-discharge healthcare utilization and costs vs hospitalized controls. Strategies are needed to improve follow-up care for children after dialysis-treated AKI to prevent long-term complications.

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Clin J Am Soc Nephrol

Acid-Base Disorders in the Critically III Patient.

The use of bicarbonate to correct the acidemia is not recommended. In patients at the extreme, the use of extracorporeal therapies to remove CO can be considered.

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Arterial Stiffness and Chronic Kidney Disease Progression in Children.

Pulse wave velocity is increased in children with CKD but does not associate with eGFR or CKD progression.

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Continuous KRT: A Contemporary Review.

We review the indications for continuous KRT and the technical aspects of the treatment, including continuous KRT modality, vascular access, dosing of continuous KRT, anticoagulation, volume management, nutrition, and continuous KRT complications. Finally, we highlight the need for close collaboration of a multidisciplinary team and development of quality assurance programs for the provision of high-quality and effective continuous KRT.

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Effect of Music in Reducing Pain during Hemodialysis Access Cannulation: A Crossover Randomized Controlled Trial.

Listening to music reduced cannulation pain in patients on hemodialysis, although there was no significant effect on anxiety, BP, or stress markers.

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Patient Preferences for Waiting Time and Kidney Quality.

Participants preferred accepting a lower-quality kidney in return for shorter waiting time, particularly those who were older and had lower functional status.

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The Relationship between Rate and Volume of Intravenous Fluid Administration and Kidney Outcomes after Angiography.

We tested for the interaction between fluid volume and duration of fluid administration, categorized as 6 hours. Mean fluid volumes <964 ml may be associated with a higher risk for the primary outcome, although residual confounding cannot be excluded.

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Clin Kidney J

COVID-19 infection and renal injury: where is the place for acute interstitial nephritis disease?

Diverse studies have focused on the effect of COVID-19 on glomerulonephritis (GN) patients or the 'novo' GN; however, the effect of COVID-19 in acute tubulointerstitial nephritis (ATIN) has been scarcely studied. In this article, we present five cases with different spectrums of COVID-19 infection and ATIN that may suggest that recent diagnosis of ATIN is accompanied by a worse clinical prognosis in comparison with long-term diagnosed ATIN.

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Development and validation of a nomogram to predict kidney survival at baseline in patients with C3 glomerulopathy.

We constructed and validated a practical nomogram with good discrimination and calibration to predict the risk of kidney failure in C3 glomerulopathy patients at 1, 2, 5 and 10 years.

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Evolving spectrum but persistent high mortality of COVID-19 among patients on kidney replacement therapy in the vaccine era: the Spanish COVID-19 KRT Registry.

The clinical presentation and outcomes of COVID-19 during the first wave no longer represent COVID-19 in KRT patients, as the pandemic has become centred around vaccinated KT recipients. Vaccines lowered the incidence of diagnosed COVID-19 and mortality. However, mortality remains high despite increased access to ICU care.

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Glomerulonephritis with non-Randall-type, non-cryoglobulinaemic monoclonal immunoglobulin G deposits (PGNMID and ITG).

Our results confirm that non-cryoglobulinaemic and non-Randall GN with monoclonal IgG deposits are rarely associated with haematological malignancy. The prognosis is uncertain but may be improved by early introduction of a specific therapy.

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Idiopathic nephrotic syndrome relapse following COVID-19 vaccination: a series of 25 cases.

This case series suggests that, in rare patients, COVID-19 vaccination may trigger INS relapse that is generally easy to control. These findings should encourage physicians to persuade their patients to complete the COVID-19 vaccination schedule.

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Kidney involvement in hereditary transthyretin amyloidosis: a cohort study of 103 patients.

CKD affects almost one-third of patients with symptomatic ATTRv. The role of ATTRv per se in the development of CKD in this population remains to be determined, but some patients may benefit from specific therapies.

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Longitudinal relationship between long sleep duration and future kidney function decline.

Average sleep durations =8 h/night were associated with an increased incidence of poor renal outcomes over time. However, a longitudinal cohort study is required to confirm whether sleep duration can prevent poor renal outcomes.

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Prescription patterns of sodium and calcium polystyrene sulfonate in patients with hyperkalemia and chronic kidney disease receiving RAAS inhibitors.

In patients with CKD receiving RAASi therapy, there is a low frequency of SPS/CPS prescription after an episode of hyperkalemia. RAASi discontinuation or downtitration is the most used pharmacologic approach for the management of hyperkalemia, a strategy that deprives patients of the cardiac and renal protective benefits of RAASi. New options for the management of hyperkalemia in this population are needed.

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Protective antibody response to mRNA-1273 and BNT162b2 vaccines in patients on maintenance haemodialysis: a prospective cohort study.

Interpretation We found an acceptable humoral response rate in patients on maintenance HD, much higher than in transplant recipients. Therefore the third dose of vaccine may be justified in those patients with an inadequate humoral response, particularly those with a history of organ transplantation or immunosuppressive treatment.

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Semaglutide for treatment of obesity in hemodialysis patients waiting for a kidney transplant: new hope?

During the 9-month follow-up, body weight loss ranged from 6.5 to 9.0 kg, ~1 kg/month. GLP-1RAs, such as semaglutide or liraglutide, could be a novel pharmacological alternative to bariatric surgeries for these HD patients.

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Serum bilirubin and kidney function: a Mendelian randomization study.

Genetic predisposition for higher serum bilirubin levels is associated with better kidney function. This result suggests that higher serum bilirubin levels may have causal protective effects against kidney function impairment.

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The incidence of cancer recurrence and new cancer following commencement of dialysis.

Among incident dialysis patients with a prior cancer history, 14% experienced cancer recurrence or developed a new cancer. Patients who experienced cancer recurrence or developed new cancer have poor outcomes, with 50% surviving beyond 3 years. These findings suggest the need to have a greater understanding of the characteristics, cancer screening, treatment responses and reasons for commencing dialysis in patients with kidney failure and prior cancer history, which may help in the shared clinical decision-making process when considering dialysis for these patients.

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Triglycerides-glucose index and the risk of cardiovascular events in persons with non-diabetic chronic kidney disease.

The TyG index is associated with the occurrence of major cardiovascular events in persons free from diabetes with non-dialysis dependent CKD.

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J Am Soc Nephrol

A Comparison of US Medicare Expenditures for Hemodialysis and Peritoneal Dialysis.

From the perspective of the Medicare program, savings associated with PD in patients =67 years have remained unchanged, despite rapid growth in the use of this dialysis modality. Total dialysis expenditures for the two modalities converged over time, whereas nondialysis expenditures diverged.

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A Novel Mouse Model of Idiopathic Nephrotic Syndrome Induced by Immunization with the Podocyte Protein Crb2.

The results highlight the causative role of anti-Crb2 autoantibody in podocyte injury in mice. Crb2 immunization could be a useful model to study the immunological pathogenesis of human INS, and may support the role of autoimmunity against podocyte proteins in INS.

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Inflammation in Children with Chronic Kidney Disease Linked to Gut Dysbiosis and Metabolite Imbalance.

Gut barrier dysfunction and microbial metabolite imbalance apparently mediate the pro-inflammatory immune phenotype, thereby driving the susceptibility to cardiovascular disease. The data highlight the importance of the microbiota-immune axis in CKD, irrespective of confounding comorbidities.

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Netrin G1 is a Novel Target Antigen in Primary Membranous Nephropathy.

NTNG1 expands the repertoire of target antigens in patients with MN. The clinical role of NTNG1-ab remains to be defined.

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Phloretin Improves Ultrafiltration and Reduces Glucose Absorption during Peritoneal Dialysis in Rats.

Taken together, our present and previous results indicate that blockers of facilitative glucose channels may be a promising target for reducing glucose absorption and improving ultrafiltration efficiency in peritoneal dialysis.

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Kidney Int

A new era for steroid-resistant nephrotic syndrome in childhood.

For those with a specific monogenic form, targeted therapy might be possible, as is the case presently for CoQ10 insufficiency cases. Further, dissecting specific causes and pathways that lead to SRNS may lead to other targeted, potentially highly effective treatments.

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Arterial stiffness, endothelial dysfunction and impaired fibrinolysis are pathogenic mechanisms contributing to cardiovascular risk in ANCA-associated vasculitis.

Patients with AAV in long-term remission have elevated cardiovascular risk and endothelin-1 contributes to this. Thus, our data support a role for endothelin-blockers to reduce cardiovascular risk by reducing arterial stiffness and increasing circulating tPA activity.

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Hemopexin Accumulates in Kidneys and Worsens Acute Kidney Injury by Causing Hemoglobin Deposition and Exacerbation of Iron Toxicity in Proximal Tubules.

Furthermore, the protective effect of deferoxamine in cisplatin-induced AKI was apparent in hemopexin wild type, but not in hemopexin knockout mice, further implicating hemopexin as a mediator of iron toxicity in AKI. Thus, our findings demonstrate that hemopexin accumulates in the kidneys and worsens kidney injury in AKI by increasing hemoglobin deposition on proximal tubular cells to exaggerate hemoglobin-induced cell injury.

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Klotho in diabetic kidney disease: more than dust in the Wnt.

Herein, Chen et al report that Klotho-derived peptide 6, a peptide mimicking the function of the protein Klotho, directly binds to endogenous Wnt ligands and, thereby, serves as a small-molecule inhibitor of canonical Wnt/ß-catenin signaling. In diabetic kidney disease, Klotho-derived peptide 6 reduces glomerular injury and preserves kidney function, highlighting Klotho-derived peptide 6 as a novel therapeutic agent.

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Natural stable calcium isotope ratios: a new gold standard for bone balance?

There are currently no clinically available tools for measuring real-time bone balance. In this issue, Shroff et al demonstrate the use of natural stable calcium isotope ratios as a novel biomarker of bone balance in children with chronic kidney disease on dialysis that is highly repeatable and associated with radiological and biochemical markers of bone metabolism.

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PHYOX2: A Pivotal Randomized Study of Nedosiran in Primary Hyperoxaluria Type 1 or 2.

In the nedosiran arm, the incidence of injection-site reactions was 9% (all mild and self-limiting). In conclusion, participants with PH1 receiving nedosiran had clinically meaningful reductions in Uox, the mediator of kidney damage in PH.

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The windows of opportunity.

However, these models have ignored the competing problem of delisting and wait-list mortality, which are equally important in the decision-making process for determining transplant suitability. This commentary focuses on a newly introduced concept that integrates and quantifies the probability of wait-list survival versus receiving a deceased donor kidney transplant.

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Nephrol Dial Transplant

Comorbidity, life-style factors and health care utilization in incident chronic kidney disease: Sex-specific analyses of claims data.

More awareness needs to be raised towards the early detection of CKD and the use of PIMs, especially in women. Improved care coordination is needed to avoid an overprovision of patients with uncomplicated incident stages and ensure that patients with advanced CKD stages get timely access to specialist care.

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Malignancies in adult kidney transplant candidates and recipients: current status.

In this article, we focus on the prevalence and outcomes of posttransplant malignancies, cancer therapy including a short overview of immunotherapy, cancer screening and prevention strategies, and immunosuppression as a cancer risk factor. The 2020/2021 recommendations of the Kidney Diseases Improving Global Outcome (KDIGO) and American Society of Transplantation (AST) for transplant candidates with a history of cancer are presented.

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Performance of creatinine-based equations to estimate glomerular filtration rate in White and Black populations in Europe, Brazil, and Africa.

In a European and African cohort, the performances of CKD-EPIAS remain suboptimal. The EKFC equation, using usual or dedicated, population-specific Q-values presents the best performance in the whole age range in the European and African populations included in this study.

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Randomized, double-blind, placebo-controlled phase 3 study of bardoxolone methyl in patients with diabetic kidney disease: Design and baseline characteristics of AYAME study.

Appropriate patients are enrolled in this study. This study will investigate the long-term efficacy and safety of bardoxolone methyl in DKD patients covering a wider range of the eGFR (=15.0 to < 60.0 mL/min/1.73 m2) and albuminuria (=3500 mg/g) compared with previous studies.

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The clinical frailty scale as a triage tool for ICU admission of dialysis patients with COVID-19 - An ERACODA analysis.

Frail dialysis patients with COVID-19 were less frequently admitted to the ICU. Large differences in mortality rates between fit and frail patients suggest that CFS may be a useful complementary triage tool for ICU admission in dialysis patients with COVID-19.

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Thrombotic microangiopathy in patients with malignant hypertension.

The presence of TMA in patients with mHTN should guide the diagnosis towards primary aHUS, drug-related mHTN, some systemic diseases and IgA nephropathy, while it is exceptional in other causes of mHTN.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Clin J Am Soc Nephrol

Improving the Utilization of Deceased Donor Kidneys by Prioritizing Patient Preferences.

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Mitigating Pain in People Undergoing Hemodialysis.

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Clin Kidney J

A promising tool: triglyceride-glucose index to stratify the risk of cardiovascular events in chronic kidney disease.

Quiroga . now show that the TyG is associated with the occurrence of major cardiovascular events in individuals free from diabetes with non-dialysis-dependent CKD.

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Expert guidance on the multidisciplinary management of cystinosis in adolescent and adult patients.

The topics covered are advice on fertility and family planning, consideration of the nervous, muscular, ophthalmic, cardio-respiratory, endocrine, dermatological and gastrointestinal systems, as well as guidance on dental care, diet, lifestyle, and improving quality of life and psychological well-being. In summary, this work outlines recommendations and a checklist for clinicians with a vision for improving and standardizing the multidisciplinary care for patients with cystinosis.

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GLP-1 receptor agonists and renal outcomes in patients with diabetes mellitus type 2 and diabetic kidney disease: state of the art.

GLP-1RAs prevent albuminuria and slow the decline of renal function towards end stage renal disease in patients with diabetic kidney disease. They might be an opportunity to break the typical inflammation processes of COVID-19 disease.

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Have we missed AINything? Acute interstitial nephritis in SARS-CoV-2 infection and vaccination.

This scenario is equally rare and causality is no less difficult to prove. A history of preceding SARS-CoV-2 infection and vaccination should be actively sought when patients present with otherwise unexplained AIN.

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Kidney replacement therapy patients with COVID-19 in the vaccine era: what do we need to know?

In their registry-based study, Quiroga . analyzed COVID-19 KRT patients in Spain across six pandemic waves in order to evaluate dynamic treatment approaches and outcomes as well as the efficacy of vaccination.

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Uric acid lowering for slowing CKD progression after the CKD-FIX trial: a solved question or still a dilemma?

However, recent randomized controlled trials failed to demonstrate a beneficial effect of allopurinol or febuxostat on renal disease, casting doubts on the role of this therapeutical approach to improve nephroprotection. We provide a critical overview of current literature on this topic and offer a possible interpretation of results from recent intervention trials with urate-lowering treatment on renal outcomes.

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Nat Rev Nephrol

Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions.

In this review, we address the impact of COVID-19 on the entire spectrum of kidney care, including acute kidney injury, chronic kidney disease, dialysis and transplantation, trainee education, disparities in health care, changes in health care policies, moral distress and the patient perspective. Based on current evidence, we provide a framework for the management and support of patients with kidney disease, infection mitigation strategies, resource allocation and support systems for the nephrology workforce.

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Vaccination in patients with kidney failure: lessons from COVID-19.

Importantly, some patients who were not able to produce antibodies still had a detectable vaccine-specific T cell response, which might be sufficient to prevent severe COVID-19. Correlates of protection against SARS-CoV-2 have not been established for patients with kidney failure, but they are urgently needed to enable personalized vaccination regimens.

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Letters&Replies

Letters to the editors and authors’ replies

Am J Kidney Dis

Best Practice Alerts in Electronic Medical Records to Improve Pneumococcal Vaccination in CKD.

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Clin Kidney J

Presentation and outcomes of SARS-CoV-2 Omicron variant infection in haemodialysis patients.

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J Am Soc Nephrol

Anti-Neu5Gc Antibodies do not Affect Response to Human or Chimeric Monoclonal Anti-CD20 Antibodies in Children with Nephrotic Syndrome.

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Kidney Int

Could Plasmodium falciparum-related kidney disease stand as another example of interferonopathy?

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Is bone histomorphometry required for assessment of renal osteodystrophy in clinical practice?

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War in Ukraine.

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Others

all remaining publications eg case reports, images of the month, etc…

Clin J Am Soc Nephrol

Current Challenges and Perspectives on Developing a Clinical Trial Design for ADPKD.

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Drug Development for Cystic Kidney Diseases.

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Getting a Kidney: Where Is Patient Choice?

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How I Treat Focal Segmental Glomerulosclerosis.

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Perspectives on Drug Development in Autosomal Recessive Polycystic Kidney Disease.

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Perspectives on Drug Development in Early ADPKD.

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Processes of Care in Survivors of Acute Kidney Injury followed in Specialized Post-Discharge Clinics.

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Clin Kidney J

Renal outcomes in immunoglobulin A nephropathy following COVID-19 vaccination: a retrospective cohort study.

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J Am Soc Nephrol

Policy and Kidney Community Engagement to Advance toward Greener Kidney Care.

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Kidney Int

A 9-year-old girl with white urine.

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Gel foam versus abscess following percutaneous kidney biopsy.

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Including APOL1 alleles and ancestry adjustments improve a genome-wide polygenic CKD score.

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The Case | An unusual cause of proteinuria in a kidney transplant recipient.

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Nat Rev Nephrol

Electronic patient-reported outcomes in chronic kidney disease.

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